Pregnancy Information Center

Information, Symptoms, Treatments and Resources


The Pregnancy Hormone Roller Coaster


Experiencing the ups and downs of pregnancy? It’s not you, it’s the hormones

By Lola Augustine Brown


Throughout pregnancy, your hormone levels fluctuate and can cause some unpredictable symptoms. If you don’t exactly feel like you’re “glowing,” and instead feel more like a blotchy, bloated and blemished blob, blame it on your hormones. If watching sappy commercials makes you burst into tears or you’re snapping at your partner over little things, chalk that up to your hormones, too. 

Just as with PMS, fluctuating pregnancy hormones can make you feel like you’re riding an emotional roller coaster, and that can be a completely normal symptom of pregnancy. But for some women, hormones can cause more serious effects, such as feeling overly emotional all the time and perhaps even anxious or depressed.

Michael E. Silverman, PhD, an assistant professor in the department of psychiatry at Icahn Medical School at Mount Sinai in New York, studies women’s moods both during and after pregnancy. He says that levels of a number of hormones fluctuate dramatically at various times during those nine months, and this can influence women in a variety of ways — just as in menstruation and menopause. “This is a spectrum issue, with some women being affected by even slight hormonal changes, while others don’t respond to significant changes,” says Silverman. 


Which Hormones Are at Play?

The first pregnancy hormone you’re likely to hear about is human chorionic gonadotropin (commonly known as hCG), which floods your body when you’re first pregnant. In fact, it’s the hormone home pregnancy tests test for. It surges in the first trimester, and is the culprit behind morning sickness. For most women, hCG levels drop by the end of the first trimester and the nausea passes. This isn’t the case for everyone, though, and as levels continue to fluctuate, hCG may also impair thyroid function and lead to hyperthyroidism, a condition that can cause anxiety, irritability and trouble sleeping, as well as a multitude of other symptoms.

The hormones estrogen and progesterone, which have many essential functions with regard to fetal growth and the changes your body needs to make to support a growing life, also fluctuate throughout pregnancy. When these hormones are at low points, it interferes with serotonin production. This can put some women at higher risk of developing depression or anxiety disorders, especially if they’ve suffered from these conditions prior to getting pregnant. Again, this isn’t universal. “The depletion of some hormones seems to contribute to maternal stress in some women, and not others,” Silverman says. 


Helping Yourself, and Seeking Help

Silverman says advises adopting good lifestyle habits to mitigate the changes your hormones put you through, namely a healthy diet, regular exercise and plenty of rest. “Many of these emotional factors are associated with not getting enough sleep during pregnancy,” he says, adding: “There’s a good deal of research demonstrating how diet and exercise practices can impact sleep.”

Depression during pregnancy is a serious concern, experts stress. “Women must get treatment for depression the same way that they would for other medical complications such as diabetes or hypertension,” says Samantha Meltzer-Brody, MD, director of the perinatal psychiatry program at the University of North Carolina. “They should not suffer in silence.”

There are a number of accepted treatments for anxiety and depression during pregnancy, from evidence-based psychotherapies to certain medications and other treatments, says Meltzer-Brody. If you’re feeling depressed, reach out to your healthcare provider and let them know what you’re going through, for your sake — and that of your baby. “Recent research suggests that stress and depression during pregnancy can have long-term developmental consequences on the offspring,” Silverman says.

And no matter how you feel while you’re pregnant — emotionally or physically — remember that it’s all just part of the process of carrying a baby, and in no way a reflection on your ability to be a mom. Be kind to yourself, and be sure to lean on your loved ones for support when you need it. 


Published on October 20, 2015.


Lola Augustine Brown is a freelance writer and mother of three whose stories appear regularly in Today’s Parent, Canadian Living, and many other publications.

Reviewed by Elisabeth Aron, MD, MPH, FACOG on July 27, 2015.
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